Clinical reasoning - ANS -Thinking process by which a nurse reaches a clinical judgement and or decision
-
Fine attunement - ANS How someone reacts and paying close attention
Critical thinking - ANS -Cognitive process used for the analysis of an issue or problem
-Kn...
Clinical reasoning - ANS -Thinking process by which a nurse reaches a clinical judgement
and or decision
-
Fine attunement - ANS How someone reacts and paying close attention
Critical thinking - ANS -Cognitive process used for the analysis of an issue or problem
-Knowledge-based
-How we think through a situation, prioritize what needs to be done first, and think about
patients' outcomes
Clinical judgement - ANS -Interpretation and conclusion about a patient's needs, concerns,
or health problems
-To either take action, improvise new ones, using or modify standard approaches deemed
appropriate for the patient
Environmental factors IMPORTANT
Nursing knowledge is NOT an environmental factor IMPORTANT - ANS -Limited staff and
equipment
-Stat med vs routine med
Increased respiratory rate - ANS First sign of sepsis
Defining attributes of clinical judgement - ANS -Holistic view of the client situation
-Process orientation
-Reasoning and interpretation
-Ethical comportment
Holistic view of client - ANS Looking at the whole person, mind, body and spirit
Process orientation - ANS -Asking the patient questions to lead to an answer
-Ability to reflect on something after it is done
-Having goals during the shift
Reasoning and interpretation - ANS Help to get to the decision
Ethical comportment - ANS -What is right and what is wrong
, Morals - ANS - Own values and beliefs
-The culture that one grew up in
Evidence based practice - ANS A problem solving approach to clinical decision making that
combines the best available scientific evidence with best available patient and practitioner
experiential evidence toward optimal healthcare outcomes
-Best evidence to inform practice
Nursing process IMPORTANT - ANS ADPIE
Assessment (see, hear, feel)
(what meds do you take? why are you here? Did anything happen in the past couple of days)
(ex: headache just developed after a car accident)
Diagnosis (analysis) (ex: head injury)
Planning (Telling the doctor the patient may need a CT scan)
Implementation (Start IV and get ready for CT) (Taking action)
Evaluation (Gets CT and gives medicine to have less of a headache)
Reflection in action - ANS Happens during the care of the patient
-Observing a patients reaction and deciding if that action has helped with the primary concern
Tanner clinical judgement model - ANS 1. Nurse's knowledge. experience, ethical
perspective, and knowing the patient
2. Noticing (assessment) *do not use your family or your symptoms as a basis*
3. Interpreting (analyzing and planning)
4. Responding (implementation)
5. Reflecting (evaluation)
Reflection on action - ANS Happens after the patient care occurs
-To see what went well or what could be better after the fact
-Usually with other people and usually about performance improvement
Clinical judgement measurement model - ANS -Layer 0 through 2 is the basis of how the
clinical judgment is made
-Layer 3 and 4 is what one expects from a nurse during study or in the room
Clinical judgement environmental factors - ANS -Environment around them
-Client oberservation
-Consequences and risks
-Time pressure
-Task complexity
-Cultural consideration
-Medical records
-Resources
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